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Cost effectiveness of fractional doses of COVID-19 vaccine boosters in India
BACKGROUND: Coronavirus disease 2019 (COVID-19) continues to be a major global public health crisis that exacts significant human and economic costs. Booster vaccination of individuals can improve waning immunity and reduce the impact of community epidemics. METHODS: Using an epidemiological model t...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier Inc.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9922587/ https://www.ncbi.nlm.nih.gov/pubmed/36827972 http://dx.doi.org/10.1016/j.medj.2023.02.001 |
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author | Du, Zhanwei Wang, Lin Bai, Yuan Feng, Shuo Ramachandran, Sabareesh Lim, Wey Wen Lau, Eric H.Y. Malani, Anup Cowling, Benjamin J. |
author_facet | Du, Zhanwei Wang, Lin Bai, Yuan Feng, Shuo Ramachandran, Sabareesh Lim, Wey Wen Lau, Eric H.Y. Malani, Anup Cowling, Benjamin J. |
author_sort | Du, Zhanwei |
collection | PubMed |
description | BACKGROUND: Coronavirus disease 2019 (COVID-19) continues to be a major global public health crisis that exacts significant human and economic costs. Booster vaccination of individuals can improve waning immunity and reduce the impact of community epidemics. METHODS: Using an epidemiological model that incorporates population-level severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission and waning of vaccine-derived immunity, we identify the hypothetical potential of mass vaccination with fractionated vaccine doses specific to ChAdOx1 nCoV-19 (AZD1222 [Covishield]; AstraZeneca) as an optimal and cost-effective strategy in India’s Omicron outbreak. FINDINGS: We find that the optimal strategy is 1/8 fractional dosing under mild (Re ∼ 1.2) and rapid (Re ∼ 5) transmission scenarios, leading to an estimated $6 (95% confidence interval [CI]: −13, 26) billion and $2 (95% CI: −26, 30) billion in health-related net monetary benefit over 200 days, respectively. Rapid and broad use of fractional dosing for boosters, together with delivery costs divided by fractionation, could substantially gain more net monetary benefit by $11 (95% CI: −10, 33) and $2 (95% CI: −23, 28) billion, respectively, under the mild and rapid transmission scenarios. CONCLUSIONS: Mass vaccination with fractional doses of COVID-19 vaccines to boost immunity in a vaccinated population could be a cost-effective strategy for mitigating the public health costs of resurgences caused by vaccine-evasive variants, and fractional dosing deserves further clinical and regulatory evaluation. FUNDING: Financial support was provided by the AIR@InnoHK Program from Innovation and Technology Commission of the Government of the Hong Kong Special Administrative Region. |
format | Online Article Text |
id | pubmed-9922587 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elsevier Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-99225872023-02-13 Cost effectiveness of fractional doses of COVID-19 vaccine boosters in India Du, Zhanwei Wang, Lin Bai, Yuan Feng, Shuo Ramachandran, Sabareesh Lim, Wey Wen Lau, Eric H.Y. Malani, Anup Cowling, Benjamin J. Med Clinical and Translational Article BACKGROUND: Coronavirus disease 2019 (COVID-19) continues to be a major global public health crisis that exacts significant human and economic costs. Booster vaccination of individuals can improve waning immunity and reduce the impact of community epidemics. METHODS: Using an epidemiological model that incorporates population-level severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission and waning of vaccine-derived immunity, we identify the hypothetical potential of mass vaccination with fractionated vaccine doses specific to ChAdOx1 nCoV-19 (AZD1222 [Covishield]; AstraZeneca) as an optimal and cost-effective strategy in India’s Omicron outbreak. FINDINGS: We find that the optimal strategy is 1/8 fractional dosing under mild (Re ∼ 1.2) and rapid (Re ∼ 5) transmission scenarios, leading to an estimated $6 (95% confidence interval [CI]: −13, 26) billion and $2 (95% CI: −26, 30) billion in health-related net monetary benefit over 200 days, respectively. Rapid and broad use of fractional dosing for boosters, together with delivery costs divided by fractionation, could substantially gain more net monetary benefit by $11 (95% CI: −10, 33) and $2 (95% CI: −23, 28) billion, respectively, under the mild and rapid transmission scenarios. CONCLUSIONS: Mass vaccination with fractional doses of COVID-19 vaccines to boost immunity in a vaccinated population could be a cost-effective strategy for mitigating the public health costs of resurgences caused by vaccine-evasive variants, and fractional dosing deserves further clinical and regulatory evaluation. FUNDING: Financial support was provided by the AIR@InnoHK Program from Innovation and Technology Commission of the Government of the Hong Kong Special Administrative Region. Elsevier Inc. 2023-03-10 2023-02-13 /pmc/articles/PMC9922587/ /pubmed/36827972 http://dx.doi.org/10.1016/j.medj.2023.02.001 Text en © 2023 Elsevier Inc. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Clinical and Translational Article Du, Zhanwei Wang, Lin Bai, Yuan Feng, Shuo Ramachandran, Sabareesh Lim, Wey Wen Lau, Eric H.Y. Malani, Anup Cowling, Benjamin J. Cost effectiveness of fractional doses of COVID-19 vaccine boosters in India |
title | Cost effectiveness of fractional doses of COVID-19 vaccine boosters in India |
title_full | Cost effectiveness of fractional doses of COVID-19 vaccine boosters in India |
title_fullStr | Cost effectiveness of fractional doses of COVID-19 vaccine boosters in India |
title_full_unstemmed | Cost effectiveness of fractional doses of COVID-19 vaccine boosters in India |
title_short | Cost effectiveness of fractional doses of COVID-19 vaccine boosters in India |
title_sort | cost effectiveness of fractional doses of covid-19 vaccine boosters in india |
topic | Clinical and Translational Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9922587/ https://www.ncbi.nlm.nih.gov/pubmed/36827972 http://dx.doi.org/10.1016/j.medj.2023.02.001 |
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